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The Impact of Structured Exercise on Brain Health in Individuals with HIV: A Pilot Study from the Brain Positive Health Now Cohort (BHN).....Improved Physical Function
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Reported by Jules Levin
9th Aging & HIV Workshop Set 13-14 NYC  
Navaldeep Kaur1,2, Lesley K Fellows3, Marie-Josée Brouillette4 and Nancy Mayo1,2 1School of Physical and Occupational Therapy, 2Division of Clinical Epidemiology, 3Department of Neurology and Neurosurgery, 4Department of Psychiatry, McGill University, Montreal, Canada
program abstract  
The Impact of Structured Exercise on Brain Health in HIV Positive Individuals  
Kaur N1, Fellows L1, Brouillette M1, Fellows L1, Mayo N1
1McGill University , Montreal, Canada  
Background: Although exercise is shown to have impact on cardiometabolic and body composition outcomes in people with HIV, the effect of exercise has not been investigated on cognitive ability. We designed a pilot study to estimate the feasibility of a 12-week combined aerobic and resistance exercise program. Also, the extent to which the program impacted on cognitive ability and brain health outcomes of motivation, fatigue and motor performance were estimated.  
Methods: The study was part of a larger project based on a cohort multiple randomized controlled design which resulted in three cohorts: exercise intervention cohort; refuser cohort and controls. Adults with sedentary lifestyle, 35 years old or above with HIV diagnosis for at least one year, without dementia and cardiovascular co-morbidities were eligible. 12-week exercise program consisted of high intensity interval training and resistance training three days per week. Cognitive ability was the primary outcome measure and was measured by Brief Cognitive Ability Measure (B-CAM) in all three cohorts.
Cognitive deficits were measured using Perceived Deficits Questionnaire (PDQ). The standardized procedures for all physical performance measures as given in the Canadian Physical Activity, Fitness and Lifestyle Approach (CPAFLA) manual were followed. Aerobic capacity was measured by a three-minute step test. Functional walking capacity, leg power, grip strength, core strength, and gait speed were measured by 6 minute walk test, vertical jump test, hand dynamometer, push ups/curl ups, and GAITrite, respectively, in the exercise intervention group. Depression and anxiety was measured with RAND 36 Mental Health Index (MHI) and fatigue with Vitality sub-scale of RAND 36. Effect sizes for all physical performance measures were reported using standardized response mean (SRM). Responder status was computed for B-CAM and change in physical performance measures was estimated using paired t-test. Effect sizes for all physical performance measures were reported using standardized response mean (SRM).  
Results: 27 people completed the exercise program. 89% of the participants completed more than 80% of the total 36 exercise sessions, thus indicating good adherence. There was no change in B-CAM and PDQ pre-and post exercise training among the three cohorts. Dual task gait speed improved in 52% of the participants. Improvement was seen in all physical performance measures (SRM ranging from 0.3 to 1.0) except for maximal jump height in the exercise cohort.  
Conclusion: The 12-week exercise program improved physical performance measures but it did not yield any gains in cognitive ability in HIV.
References: Mayo, N., Brouillette, M., Fellows, L., & Positive Brain Health Now Investigators. (2016). Understanding and optimizing brain health in hIV now: Protocol for a longitudinal cohort study with multiple randomized controlled trials. Bmc Neurology, 16, 8-8. doi:10.1186/s12883-016-0527-1
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